Deep-vein thrombosis and coumarin skin necrosis associated with a factor V inhibitor with lupus-like features.
We report a 71-year-old man who developed deep-vein thrombosis after major surgery. Coumarin skin necrosis developed after starting oral anticoagulant therapy. An inhibitor to factor V (61 Bethesda units) with lupus-like features was found as well as a low protein C level. The occurrence of these very rare findings indicates that despite profound procoagulant inhibition (factor V inhibition and anticoagulant therapy), hypercoagulation can occur.
Kamphuisen
P W
PW
Haemostasis and Thrombosis Research Center, Department of Haematology, University Hospital Leiden, The Netherlands.
Haan
J
J
Rosekrans
P C
PC
Van Der Meer
F J
FJ
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D003374:Coumarins / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000276:immunology* / Q000473:pathology; D005165:Factor V / Q000037:antagonists & inhibitors / Q000276:immunology*; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000276:immunology*; D008297:Male; D009336:Necrosis; D013924:Thrombophlebitis / Q000188:drug therapy*
D000925:Anticoagulants; D003374:Coumarins; D016682:Lupus Coagulation Inhibitor; D005165:Factor V; C030123:coumarin